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Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
40 50512 HYDROGEN PEROXIDE 6% (FED/ATB) HYDROGEN PEROXIDE HYDROGEN PEROXIDE 150ML B 2.58 0.02 SOLUTION 0 ML FED FEDERATED PHARMACEUTICAL CO. LT ATB ANSA TRADING BARBADOS LTD 5228 MOUTH WASHES AND GARGLES 2022-05-11 2024-03-31 Change Local Agent TOPICAL 0 EYE, EAR, NOSE AND THROAT PREPARATIONS 2022-05-11
40 50514 HYDROGEN PEROXIDE 6% (FED/RXP) HYDROGEN PEROXIDE HYDROGEN PEROXIDE 150ML B 2.58 0.02 SOLUTION 0 ML FED FEDERATED PHARMACEUTICAL CO. LT RXP RX PRO INC 5228 MOUTH WASHES AND GARGLES 2022-04-01 2022-05-11 Delete from contract TOPICAL 0 EYE, EAR, NOSE AND THROAT PREPARATIONS 2022-05-11
40 5051H HYDROGEN PEROXIDE 6% (THR/SBI) HYDROGEN PEROXIDE HYDROGEN PEROXIDE 200ML B 1.85 0.01 SOLUTION 0 ML THR THORNTON & ROSS LTD SBI MASSY DISTRIBUTION (BDOS) LTD 5228 MOUTH WASHES AND GARGLES 2022-04-01 2024-03-31 TOPICAL 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 5051M HYDROGEN PEROXIDE 6% SOLN (LDP) (B) HYDROGEN PEROXIDE HYDROGEN 250ML B 4.87 0.0195 ML 0 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 TOPICAL 0 IMMUNOSUPPRESSIVE AGENTS
42 5051M HYDROGEN PEROXIDE 6% SOLN (LDP) HYDROGEN PEROXIDE HYDROGEN 250ML B 5.46 0.02 ML 0 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 9244 IMMUNOSUPPRESSIVE AGENTS 2026-04-01 TOPICAL 0 IMMUNOSUPPRESSIVE AGENTS